Slow-transit constipation with concurrent upper gastrointestinal dysmotility and its response to transcutaneous...

Area of Science:

• Pediatric Gastroenterology
• Gastrointestinal Motility Disorders
• Neuromodulation Therapies

Background:

• Slow-transit constipation (STC) is a common condition in children.
• Transcutaneous electrical stimulation (TES) has shown promise in accelerating colonic transit in pediatric STC.
• The impact of concurrent upper gastrointestinal dysmotility (UGD) on TES response in STC is not well understood.

Purpose of the Study:

• To evaluate the efficacy of TES in children with STC.
• To determine if the presence of UGD influences the response to TES in children with STC.

Main Methods:

• A randomized controlled trial involving radio-nuclear transit studies (NTS) before and after TES treatment for STC.
• UGD was diagnosed based on delayed gastric emptying and/or slow small bowel transit.
• Treatment response was measured by an increase in Geometric Centre (GC) of ≥1.

Main Results:

• Active TES significantly increased colonic transit in over 50% of subjects compared to 25% with sham stimulation (p=0.04).
• Children with STC and normal upper GI motility (NUGM) showed a significantly greater increase in mean transit rate compared to those with UGD.
• While NTS improved in both groups with STC, the magnitude of improvement was less pronounced in children with UGD.

Conclusions:

• TES is a beneficial treatment for STC in children.
• The response to TES in STC may be weakly associated with the presence of UGD.
• Further research with larger cohorts is needed to definitively establish the clinical significance of UGD on TES efficacy in STC.